A Surgeon’s Funeral

He was a surgeon to know and admire
To snatch the fat from out of the fire
He came to the ill
With grace and with skill
A light when things were most dire.

Synopsis: I’m a family practitioner from Sioux City, Iowa. I danced back from the brink of burnout in 2010, and, honoring a one-year non-compete clause, went for adventures working in out-of-the-way locations. After jobs in Alaska, New Zealand, Iowa, and Nebraska, I returned home and took a part-time position with a Community Health Center, where I worked for 3 years. I left last month because of a troubled relationship with the Electronic Medical Record (EMR) system. Now I’m back from a road trip, working a bit with one of the rural docs, and getting ready for another job in Alaska.
Medicine has always been a team sport.
When I first came into private practice from 5 years in the Indian Health Service, I had to get to know the specialists. In less than a year, I established a reputation as a sharp diagnostician. In retrospect, though, it seemed to me that very complex clinical situations presented themselves to me in such an obvious fashion that I could make an outstanding diagnosis and look like a hero.
For example, I diagnosed 8 women with ectopic pregnancy in 6 months. The principle has long stood that any woman of childbearing potential with abdominal pain has ectopic pregnancy until proven otherwise; I embraced that piece of wisdom and saved lives. But each one presented on a different gynecologist’s call night, so that in short order my consultants came to trust my judgment.
On one particular night, I called a surgeon and said (the patient’s identifying data may or may not be precise) “I got a 14-year-old white male with increasing abdominal pain times three days, originally vague and near the umbilicus (navel) now localized to the right lower quadrant, worse with jarring, accompanied by loss of appetite. No major medical problems in the past. He has decreased bowel sounds, a little guarding, tender at McBurney’s point, rebound, referred pain to the right lower quadrant, and positive heel, psoas and bunny hop signs. He did not enjoy his lunch. Blood and urine are normal. I think he has appendicitis, and I’d appreciate it if you’d see him.”
In those days the primary care doc scrubbed in with the surgeon as assistant. I watched in awe as he flowed through the surgery in less than 5 minutes; poetry in motion and economy of movement really don’t do justice to the beauty of how his hands worked. Before the advent of laparoscopic surgery, he could do an appendectomy with an incision less than an inch long.
The guy was slick.
We did a lot of those cases together, and as the critical first months in a new medical community passed, I built such trust with my consultants that I could say, “Hey, Don, you wanna go fishin?”
We worked well together.
As medicine progressed, we both aged. He retired a number of years ago.
He died last week, and I went to the funeral today.
I saw a lot of the docs I knew from those days; a urologist who had left town last century, a half-dozen Family Practice docs, three surgeons who had worked with Don back in the day, two pathologists, a radiologist; some retired and some still working.
The service had a light mood; Don had a full life and enjoyed tremendous respect.
I held the door for the widow after the internment. I hadn’t known her to speak of but she looked at me and stopped and addressed me by name. “Don thought the world of you,” she said, “He said you were one of the sharpest doctors in town. He admired you.”
I hadn’t known that. It meant a lot to me.
“I admired him,” I said.


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